Clinical features
The clinical features of a biliary fistula include:
- biliary peritonitis - caused by leakage of bile into the peritoneal cavity. It is associated with an elevated conjugated serum bilirubin, due to absorption of bile from the peritoneal cavity, and later, with an elevated serum alkaline phosphatase, probably due to pericholangitis
Usually, there is:
- fever
- abdominal tenderness
Rarely, the peritonitis is more indolent. There is:
- mild jaundice }
- abdominal distension } bile ascites
There is also likely to be cholangitis.
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